Acute Coronary Syndromes in Women Including MINOCA

Among patients admitted to the emergency departments with suspected acute coronary syndrome (ACS), half of them are women and most likely present with non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA). Sex differences in pathophysiology, clinical presentation, diagnosis, and treatment have an important impact on clinical outcomes. Women with ACS may have traditional and/or sex-specific risk factors and more frequently than men have non-atherosclerotic involvement of coronary arteries. Over the last decades, ACS mortality has dramatically decreased due to better treatment. However, women still have a higher short term mortality risk after successful percutaneous coronary intervention (PCI) compared with men. Women are less likely to undergo evidence-based and guideline-recommended diagnostic and revascularization pathways. The scientific community hasn’t adequately addressed gaps in knowledge in the diagnosis and treatment of women presenting with ACS.